Free Homeroom Roster List Template
Homeroom Roster List
Name : [Your Name]
Address : [Your Address]
Date : [Date]
This preparedness roster is designed to help our homeroom teachers and students respond appropriately and efficiently during emergencies. The list includes details like evacuation route, assembly point, student roster, teacher and staff roster, emergency contact information, special instructions for specific individuals, and the list of emergency supplies.
Homeroom Details
|
Homeroom Number |
101 |
|---|---|
|
Homeroom Teacher |
Ms. Smith |
|
Evacuation Route |
Staircase B to Main Exit |
|
Assembly Point |
Secondary School Playground |
Student Roster
|
Student Name |
Notes |
|---|---|
|
Jessica |
Asthmatic, carries own inhaler |
|
Liam |
Allergic to peanuts |
|
Emily |
Requires extra time for exams |
|
Noah |
Gluten intolerant |
|
Ava |
Visual impairment, uses a cane |
|
Ethan |
ADHD, may need occasional breaks |
Teacher and Staff Roster
|
Name |
Role |
Notes |
|---|---|---|
|
Ms. Smith |
Homeroom Teacher |
First Aid Certified |
|
Mr. James |
Assistant |
Can operate AED |
Emergency Contact Information
|
Contact Person |
Relationship |
Phone Number |
|---|---|---|
|
Sarah Johnson |
Parent |
(555) 123-4567 |
|
Mark Davis |
Guardian |
(555) 987-6543 |
|
Lisa Anderson |
Emergency Contact |
(555) 789-0123 |
|
James Smith |
Relative |
(555) 456-7890 |
|
Emily White |
Parent |
(555) 234-5678 |
Special Instructions
Add special instructions here that are relevant to the homeroom students and staff members. For example, if a student has a mobility issue, include instructions for their safe evacuation.
Emergency Supplies
|
Item |
Quantity |
|---|---|
|
First Aid Kit |
1 |
|
Water Bottles |
15 |
Notes:
-
This roster is crucial for a quick and organized response during emergencies.
-
Regularly update the information to ensure accuracy.
-
Practice evacuation drills to familiarize everyone with the procedures.
